Absolute No-No's
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Hi: I hope to get a lot of input from this question. As experienced nurses, what are some things especially related to medication administration, but anything else, that you would classify in red... Read More

Dec 10, '07

Always check for allergies!! Called Dr. because pt was in pain. Dr. ordered morphine,pulled up medication, went into pt's room to give drug. Pt's family asked what the drug was--found out pt was allergic to morphine!! Should have check pt's allergies first,narrowly avoided a serious or potentially fatal error.

Dec 10, '07

Oh that reminds me of my own experience. Just because the doc didn't list my allergy on the "admit from ER orders", BELIEVE me (and my medic-alert bracelet-paid $40 for that thing-) that I am allergic to _________. I had a very BAD adverse reaction to a certain drug previously and here you are trying to give it to me again.....thank goodness for my assertive hubby.

Dec 10, '07

"I want you to remember this statement when you have an 8 patient assignment on a floor when you are supposed to only have 5, the CNA and the Unit Clerk are out sick with a stomach virus which you know you will have tommorow. Your med pass is an hour behind, your three incontinent patients all need to be changed, two IVs just blew, one patient has a bp of 89/55 and the house intern hasn't responded to two pages."

Definitely does not take that long to make sure of the 5 rights when giving meds. best thing--just slow down a minute, and you will probably save a few. Remember the ABCs, if the med is not that critical--a few minutes or half hour or hour(s) sometimes won't kill someone. Not being thorough and checking, though, can.

ewwwwwwwwwww!!! yuck, and gross!
come to think of it, i've seen this done too. seasoned nurses who will handle blood products, iv's (inserting), and colostomy care barehanded (i think it was the woc nurse!!)

as if they are truly not going to get slimed? i know that tape part is problematic, but.....
:smackingf

[font="comic sans ms"]prior to about 1985, we did everything without gloves. there weren't any gloves available for us to use except the one box that was kept in the dirty utility room for the intern to use when they did a rectal exam. once you've spent a decade doing nursing care without gloves, sometimes you forget to don gloves before hanging blood, and as for starting an iv -- i learned without gloves. i have a lot of difficulty starting them with.

[font="comic sans ms"]prior to about 1985, we did everything without gloves. there weren't any gloves available for us to use except the one box that was kept in the dirty utility room for the intern to use when they did a rectal exam. once you've spent a decade doing nursing care without gloves, sometimes you forget to don gloves before hanging blood, and as for starting an iv -- i learned without gloves. i have a lot of difficulty starting them with.

yes, my retired msn-rn mom has told me these same stories.

doesn't mean it's right. besides we know better now, don't we. and they spent each semester pounding the universal precautions into our heads in ns between 2005-2007. it was even on nclex.

no excuses.

Dec 10, '07

No judgements either, not between colleagues.

Dec 10, '07

That "we" that I wrote means WE, as in you AND me. Goes along w/ handwashing and being carriers of infection (gosh wish I could remember the fancy name; or is it Vector?)

What is w/ people on this forum lately? Too many arguments all the way around!!

I didn't mean to attack anyone. I HAVE heard these same stories.
Such as cleaning out gloves and reusing them after blowing them up to check for holes, or the glass IV bottles that were drained and re-used

There are more tales of yeseteryear, but my mom sitting next to me now just cannot recall this late.

Stop attacking y'all! This is supposed to be a forum for healthy debate and trading knowledge.

Dec 10, '07

always clearly document the medication, dosage, and time you give a med. waiting to document is a big no, no! this doesn't just benefit the next nurse that get the chart, but also helps the hospital determine how much meds to order, what to bill for and the list goes on....failure to document a few drugs may result in failed audits and financial loss for the hospital. lots of hospitals go by criteria (interqual) to establish medical necessity. one dosage not documented may determine medical necessity for admit or continued hospitalization.

Oh that reminds me of my own experience. Just because the doc didn't list my allergy on the "admit from ER orders", BELIEVE me (and my medic-alert bracelet-paid $40 for that thing-) that I am allergic to _________. I had a very BAD adverse reaction to a certain drug previously and here you are trying to give it to me again.....thank goodness for my assertive hubby.

Amen.

I have a latex allergy. It IS listed on my charts and orders when I'm admitted. I tell everyone who cares for me I have a latex allergy. And yet I still encounter nurses who will try to tell me it won't hurt me if they use latex while caring for me. I stayed awake for over 24 hours straight after my last 2 surgeries, and stopped multiple nurses as they came at me with latex gloves and tournequets, etc. I had to request (multiple times) a sign be placed regarding the allergy and that non-latex gloves be stocked in the room. The docs and CNAs and other staff never questioned me and used the appropriate equipment. Only the nurses were hell-bent on using latex products for my care...

Always make sure the patient takes all the meds before you leave the room. I've gone in to rooms and seen meds sitting on the patients bedside table that were from the previous shift. I've seen nurses get fired for this.

I work in LTC and I've seen a lot of nurses get written up for this same problem, some of the residents take the medicine and hold it in their mouths, there is this one little lady that takes like 10 min to take her pills, and even after that I'm still not sure she's got them down, i usually pass by her room again just to make sure she didnt put them in her cup or in the bed!

Dec 11, '07

oh yes latex....... i once broke out so bad on my hands i actually thought i had kaposi's sarcoma. i had these big bleebs full of blood all over the backs of my hands. i was off for christmas day and the day after<-that's a legal holiday in sc..so i called a dermatologist i knew and he opened his office. he took one look and said you are allergic to latex.
employee health wouldn't accept that and made me have a titre. off the charts!!! then the told me i'd have to buy my own gloves. attorney took care of that.

but what helped more than all this is i ate some guacomole and about anaphylaxed.
related to latex sources. then they believed me when i almost needed tubing.

so to reiterate believe your patient if he says he's allergic even if the doc forgot to include it .
[[color=sandybrown]i have latex, betadine, certain narcotic, and avocados on that $40 bracelet.]

Dec 11, '07

I once stopped a new grad RIGHT before she was about to give Levophed- she was going to give it IV push, instead of hanging a drip! YIKES! If you haven't given a med before, LOOK IT UP!

oh yes latex....... i once broke out so bad on my hands i actually thought i had kaposi's sarcoma. i had these big bleebs full of blood all over the backs of my hands. i was off for christmas day and the day after<-that's a legal holiday in sc..so i called a dermatologist i knew and he opened his office. he took one look and said you are allergic to latex.
employee health wouldn't accept that and made me have a titre. off the charts!!! then the told me i'd have to buy my own gloves. attorney took care of that.

but what helped more than all this is i ate some guacomole and about anaphylaxed.
related to latex sources. then they believed me when i almost needed tubing.

so to reiterate believe your patient if he says he's allergic even if the doc forgot to include it .
[[color=sandybrown]i have latex, betadine, certain narcotic, and avocados on that $40 bracelet.]

makes me feel so bad for the sweet lil lady who turned terminal once dx'd w/ mets on my onc unit, and tended to go to alert and confused. really confused! staff griped and made fun of her during report for saying in add'n to her many allergies that now cherry jello and eggs were being added to her allergies.

why is this to be made fun of?

when i asked why this was funny, as the new grad, i was put in my place by stern words and/or cold shoulder snubs.

does there have to be a near death experience before a pt is believed?